Pain relief after surgery

Operations cause pain and people who have good pain control after their operations are less likely to suffer from heart attacks, chest infections and blood clots. They also get up and about more quickly and may get home sooner. Before your operation your nurse or anaesthetist will be able to advise which is the most suitable forms of pain relief for you. If you are in a lot of pain, do ask for pain relief. Although none of them can be guaranteed to make you absolutely pain-free, they should help you not to be in a lot of pain after your operation.

Simple painkillers

You can use these drugs on their own or combined with other painkillers. After your operation you should use simple painkillers regularly such as paracetamol, anti-inflammatory drugs (for example, ibuprofen and diclofenac) and codeine or similar drugs (for example, dihydrocodeine, oxycodone and tramadol). Although these drugs may not completely treat your pain, if you take them regularly they reduce the amount of other painkillers you might need. Some people cannot take simple painkillers for various reasons. It is important that you let your anaesthetist know before your operation if you have had any problems with these types of drugs before, or if you have a history of stomach ulcers, kidney damage, bleeding or asthma.

Possible complications

Paracetamol is exceptionally safe in normal doses Anti-inflammatory drugs can sometimes cause stomach irritation. This can be more severe with ulcers or stomach bleeding Anti-inflammatory drugs can make asthma worse, but most people with asthma are not affected Codeine or similar drugs can make you feel sick or light-headed. They can make you itch and almost always cause some degree of constipation. This is not a definitive list and symptoms will vary with each patient. Please ask your doctor for more information.

Morphine and similar drugs

For more severe pain you may be prescribed morphine or similar drugs such as pethidine or diamorphine.

Possible complications

  • Itching is common, but not usually severe 
  • Constipation is common
  • Sickness or feeling sick, which can usually be treated
  • Respiratory depression, where your breathing slows down too much. 
  • Serious complications are rare. 
  • Your oxygen levels will be monitored

This is not a definitive list and symptoms will vary with each patient. Please ask your doctor for more information.

Intravenous delivery (using a drip)

The most common intravenous delivery is a technique known as patient-controlled analgesia (PCA). A special pump, containing the drugs, is connected to a drip (small tube) in one of your veins. If you are in pain, press the button and a small dose of drugs will be given. The pump has several safety features so you can’t overdose by accident.

Other ways of giving morphine and similar drugs

The drugs can be given by injection either under the skin (subcutaneous) or into the muscle (intramuscular). If it is given by injection under the skin, a small plastic tube (similar to a drip) is sometimes left under the skin to avoid repeatedly inserting a needle. The drugs can also be given by mouth once you are eating and drinking normally.

Patient-controlled analgesia

Most people prefer PCA to injections. At busy times the nurses may not be able to respond to your request for pain relief straightaway. Your anaesthetist will discuss the suitability of this procedure with you.

Epidural anaesthetic

Some people may be offered epidural pain relief after their operation. Epidural pain relief involves inserting a fine catheter (small tube) into an area called the epidural space in your back. All your nerves pass through this space. Local anaesthetics and other painkilling drugs are injected down the catheter into the epidural space to numb your nerves. Epidurals provide good pain relief but, like other forms of pain relief, cannot guarantee that you’ll be pain-free. Sometimes the drugs are injected continuously (an infusion) and the dose varied, if needed, by the nurses. As well as continuous infusion, you can sometimes have a button that allows you to top up the epidural by giving a small, safe dose when you need it.

Possible complications

  • The injection fails to relieve your pain
  • The epidural injection makes your pain worse. This usually settles quickly.
  • Low blood pressure, which is common and can be treated straightaway
  • A particular type of headache that can happen if the bag of fluid is around the spinal cord is punctured. This type of headache can be treated. 
  • Seizures, due to the local anaesthetics, which is rare and is usually temporary
  • Temporary leg or arm weakness
  • Backache – it is common to experience a bruised feeling where the injection was given a few days after, but will settle
  • Infection around the spine
  • Short-term/long-term nerve injury, which is rare. 
  • A blood clot in the spine, which is rare. 
This is not a definitive list and symptoms will vary with each patient. Please ask your doctor for more information.

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